How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,365.16 | Professional | None | $3,548.13 | $3,548.13 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $7,413.10 | Facility | None | $6,025.60 | $6,025.60 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $6,760.83 Median $9,549.93 Typical High $12,022.64 | Professional | None | $6,760.83 | $9,549.93 | $12,022.64 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $4,570.88 Typical High $6,025.60 | Facility | None | $758.58 | $4,570.88 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $4,265.80 Median $10,000.00 Typical High $31,622.78 | Professional | None | $4,265.80 | $10,000.00 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | None | $9,549.93 | $9,549.93 | $9,549.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $4,365.16 Median $6,456.54 Typical High $8,511.38 | Professional | None | $4,365.16 | $6,456.54 | $8,511.38 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $3,981.07 Median $8,912.51 Typical High $12,022.64 | Professional | None | $3,981.07 | $8,912.51 | $12,022.64 |
Wellmark Setting Professional Modifier None Typical Low $9,120.11 Median $10,715.19 Typical High $10,715.19 | Professional | None | $9,120.11 | $10,715.19 | $10,715.19 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 53 · Discontinued | $707.95 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $436.52 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $3,090.30 |
Where South Dakota sits
The same service costs 21.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 4th of 51
$9,120
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.